Imaging prices at Dominican Hospital
Santa Cruz, CA · every code in this section with a posted price and a Medicare benchmark.
260 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $384.75 | $855 | 3.0× |
| Abdomen 2 views (74019) | $638.55 | $1,419 | 4.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,342.25 | $5,205 | 4.0× |
| Angio pulmonary bilat (75743) | $4,131.45 | $9,181 | 0.9× |
| Angiography extremity bilateral rs&i (75716) | $4,041.45 | $8,981 | 0.9× |
| Aortography thoracic serialography rs&i (75605) | $4,922.55 | $10,939 | 0.6× |
| Aortography thoracic w/o serialography rs&i (75600) | $3,533.85 | $7,853 | 0.8× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$3,368.70–$3,509.10 | $7,486–$7,798 | varies |
| Artery X-Rays Pelvis (75736) | $8,537.85 | $18,973 | 1.0× |
| Bone age studies (77072) | $339.30 | $754 | 2.2× |
| Bone Imaging 3 Phase (78315) | $4,194.90 | $9,322 | 7.2× |
| Bone Imaging Limited Area (78300) | $2,173.05 | $4,829 | 3.7× |
| Bone Imaging Multiple Areas (78305) | $2,776.50 | $6,170 | 4.7× |
| Bone Imaging Whole Body (78306) | $3,018.15 | $6,707 | 5.2× |
| Bone marrow imaging; multiple areas (78103) | $1,057.05 | $2,349 | 1.8× |
| Bone survey infant (77076) | $1,053.45 | $2,341 | 6.9× |
| Brain Flow Imaging Only (78610) | $805.95 | $1,791 | 1.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,353.60 | $3,008 | 1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,861.90 | $8,582 | 1.8× |
| Cardiac Shunt Detection (78428) | $980.10 | $2,178 | 1.7× |
| Cat Scan Follow-Up Study (76380) range across 4 matching MRF lines |
$1,385.55–$2,751.75 | $3,079–$6,115 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,871.10 | $4,158 | 2.4× |
| Cerebrospinal Fluid Scan (78630) | $1,967.85 | $4,373 | 2.5× |
| Chest 1 view (71045) | $422.10 | $938 | 3.3× |
| Chest 2 views (71046) | $549 | $1,220 | 4.3× |
| Chest 3 views (71047) | $582.75 | $1,295 | 4.6× |
| Chest 4 or more views (71048) | $620.55 | $1,379 | 4.1× |
| Cholecystography Oral Contrast (74290) | $649.80 | $1,444 | 2.5× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $415.35 | $923 | 2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $141.75 | $315 | 0.9× |
| Contrast Exam Abdominl Aorta (75625) | $3,090.60 | $6,868 | 0.7× |
| Contrast X-Ray Bladder (74430) | $441 | $980 | 0.9× |
| Contrast Xray Throat/Cerv Esopha (74210) | $688.50 | $1,530 | 2.7× |
| CT abdomen and pelvis without and with contrast (74178) | $10,388.70 | $23,086 | 20.4× |
| CT abdomen and pelvis without contrast (74176) | $5,949 | $13,220 | 17.0× |
| CT abdomen w contrast (74160) | $5,896.80 | $13,104 | 23.0× |
| CT abdomen w wo contrast (74170) | $6,857.10 | $15,238 | 26.7× |
| CT abdomen w/o contrast (74150) | $3,839.85 | $8,533 | 25.1× |
| CT Angio Abdomen and Pelvis (74174) | $6,534.90 | $14,522 | 12.8× |
| CT Angio Chest (71275) | $6,547.50 | $14,550 | 25.5× |
| CT Angio Head (70496) | $4,612.05 | $10,249 | 18.0× |
| CT angio hrt w/3d image (75574) | $406.35 | $903 | 0.8× |
| CT Angio Neck (70498) | $3,862.35 | $8,583 | 15.1× |
| CT cervical spine w/ contrast (72126) | $5,552.55 | $12,339 | 10.9× |
| CT cervical spine w/o contrast (72125) | $4,477.95 | $9,951 | 29.3× |
| CT chest w contrast (71260) | $4,723.65 | $10,497 | 18.4× |
| CT chest w/wo contrast (71270) | $5,857.65 | $13,017 | 22.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $159.30 | $354 | 1.0× |
| CT head/brain with contrast (70460) | $4,129.20 | $9,176 | 16.1× |
| CT head/brain without and with contrast (70470) | $4,943.25 | $10,985 | 19.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $244.80 | $544 | 1.9× |
| CT iac w contrast (70481) | $3,499.65 | $7,777 | 13.6× |
| CT lumbar spine w contrast (72132) | $5,529.60 | $12,288 | 10.8× |
| CT lumbar spine w/o contrast (72131) | $4,388.85 | $9,753 | 28.7× |
| CT maxillofacial w contrast (70487) | $4,570.65 | $10,157 | 17.8× |
| CT maxillofacial wo contrast (70486) | $3,777.30 | $8,394 | 24.7× |
| CT neck tissue combo (70492) | $4,626 | $10,280 | 18.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,849.75 | $8,555 | 15.0× |
| CT orbits w/o contrast (70480) | $2,974.50 | $6,610 | 19.5× |
| CT pelvis w&w/o contrast (72194) | $4,266 | $9,480 | 16.6× |
| CT pelvis w/o contrast (72192) | $1,921.50 | $4,270 | 12.6× |
| CT soft tissue neck w contrast (70491) | $3,887.10 | $8,638 | 15.1× |
| CT soft tissue neck w/o contrast (70490) | $3,226.50 | $7,170 | 21.1× |
| CT thoracic spine w contrast (72129) | $6,393.15 | $14,207 | 24.9× |
| CT thoracic spine w/o contrast (72128) | $5,073.75 | $11,275 | 33.2× |
| CT thorax w/o contrast (71250) | $2,409.30 | $5,354 | 15.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $5,565.15 | $12,367 | 21.7× |
| Cta Abdomen (74175) | $4,639.95 | $10,311 | 18.1× |
| CTA pelvis (72191) | $3,527.10 | $7,838 | 13.7× |
| Dilation ureters/urethra rs&i (74485) | $2,123.10 | $4,718 | 0.7× |
| Discography Cerv/Thor Spine (72285) | $2,360.70 | $5,246 | 0.8× |
| Diskography lumbar (72295) | $2,360.70 | $5,246 | 0.8× |
| Doppler Fetal Mid Cerebral Artery (76821) | $430.20 | $956 | 2.8× |
| Echo Guide For Artery Repair (76936) | $1,638.90 | $3,642 | 5.2× |
| Echograp Trans R Pros Study (76873) | $6,178.50 | $13,730 | 40.4× |
| Esophagram (74220) range across 2 matching MRF lines |
$698.40–$727.65 | $1,552–$1,617 | varies |
| Fetal Biophys Profile W/Nst (76818) | $626.40 | $1,392 | 4.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,062 | $2,360 | 6.9× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$943.65–$983.25 | $2,097–$2,185 | varies |
| Follow-Up Angiography (75898) | $2,659.50 | $5,910 | 0.6× |
| Gastric emptying imaging study (78264) | $2,454.30 | $5,454 | 4.2× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $486.90 | $1,082 | 0.8× |
| Gastroesophageal Reflux Exam (78262) | $1,557 | $3,460 | 2.7× |
| Gated Heart Planar Single (78472) | $2,393.10 | $5,318 | 4.1× |
| Gated Heart, Multiple (78473) range across 2 matching MRF lines |
$2,367–$2,461.05 | $5,260–$5,469 | varies |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $646.20 | $1,436 | 0.8× |
| Heart first pass single,planar (78481) | $2,394 | $5,320 | 3.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,105.25 | $11,345 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $5,095.80 | $11,324 | 6.4× |
| Hepatobiliary System Imaging (78226) | $3,719.70 | $8,266 | 6.4× |
| Ht Muscle Image Spect Sing (78451) | $3,024.90 | $6,722 | 1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,014.75 | $2,255 | 8.0× |
| Interstitial radiation source applic complex (77778) | $901.35 | $2,003 | 0.9× |
| K Flow/Funct Image W/Drug (78708) | $2,930.85 | $6,513 | 3.7× |
| K Flow/Funct Image W/O Drug (78707) | $3,927.60 | $8,728 | 4.9× |
| Kidney Imaging Morphol (78700) | $2,960.10 | $6,578 | 5.1× |
| Leveen/Shunt Patency Exam (78291) | $1,556.55 | $3,459 | 2.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $2,015.55 | $4,479 | 3.4× |
| Liver imaging static only (78201) | $1,294.20 | $2,876 | 1.6× |
| Liver imaging w/vascular flow (78202) | $1,294.20 | $2,876 | 1.6× |
| Lung Perf&Ventilat Diferentl (78598) | $4,637.25 | $10,305 | 5.8× |
| Lung perfusion differential (78597) | $4,032.45 | $8,961 | 6.9× |
| Lung Ventilat&Perfus Imaging (78582) | $3,064.05 | $6,809 | 3.9× |
| Lung Ventilation Imaging (78579) | $1,715.85 | $3,813 | 2.9× |
| Lymph System Imaging (78195) | $3,534.30 | $7,854 | 4.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $6,503.40 | $14,452 | 1.4× |
| Magnetic Image Jaw Joint (70336) | $2,406.15 | $5,347 | 6.9× |
| Meckels Divert Exam (78290) | $1,577.70 | $3,506 | 2.7× |
| Mr safety determination physician/other qhp (76016) | $163.35 | $363 | 1.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $45 | $100 | 1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $170.10 | $378 | 1.2× |
| Mr safety implt pos&/immoblj (76019) | $110.25 | $245 | 1.3× |
| Mr safety med physics xm customization plng&mntr (76017) | $448.20 | $996 | 1.3× |
| Mra Head W/O & W/Contrast Material (70546) | $4,538.70 | $10,086 | 8.9× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$713.25–$2,966.40 | $1,585–$6,592 | varies |
| MRA head with contrast (70545) | $4,538.70 | $10,086 | 8.9× |
| MRA neck w contrast (70548) | $3,755.70 | $8,346 | 7.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,755.70 | $8,346 | 7.4× |
| MRA neck w/o contrast (70547) | $2,441.25 | $5,425 | 7.0× |
| MRI abdomen w contrast (74182) | $3,759.75 | $8,355 | 7.4× |
| MRI abdomen w/o contrast (74181) | $2,441.25 | $5,425 | 7.0× |
| MRI cervical spine w contrast (72142) | $4,051.80 | $9,004 | 7.9× |
| MRI cervical spine w/o cont (72141) | $2,648.25 | $5,885 | 7.6× |
| MRI chest w/o contrast (71550) | $2,167.65 | $4,817 | 6.2× |
| MRI chest with contrast (71551) | $3,434.40 | $7,632 | 3.0× |
| MRI chest wo w contrast (71552) | $3,568.05 | $7,929 | 7.0× |
| MRI lumbar spine w contrast (72149) | $3,835.35 | $8,523 | 7.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,051.80 | $9,004 | 7.9× |
| MRI orbit face &/neck w/o contrast (70540) | $978.75 | $2,175 | 2.8× |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$1,074.60–$3,568.05 | $2,388–$7,929 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$1,193.40–$3,568.05 | $2,652–$7,929 | varies |
| MRI pelvis w contrast (72196) | $3,861 | $8,580 | 7.6× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,193.40–$4,131.45 | $2,652–$9,181 | varies |
| MRI pelvis w/o contrast (72195) | $2,685.15 | $5,967 | 7.7× |
| MRI thoracic spine w/o contrast (72146) | $2,441.25 | $5,425 | 7.0× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,196.10–$3,759.75 | $2,658–$8,355 | varies |
| MRI, dorsal spine combo (72157) | $3,755.70 | $8,346 | 7.4× |
| MRI, dorsal spine contrast (72147) | $3,868.20 | $8,596 | 7.6× |
| MRI, lumbar spine combo (72158) | $3,835.35 | $8,523 | 7.5× |
| Myelogram cervical (72240) | $2,306.70 | $5,126 | 2.0× |
| Myelogram Lumbar (72265) | $2,334.15 | $5,187 | 2.0× |
| Myelography thoracic (72255) | $772.20 | $1,716 | 0.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,827.90 | $4,062 | 1.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,540.80 | $3,424 | 2.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $3,024.90 | $6,722 | 1.6× |
| Myocardial Spect Multiple Studies (78452) | $3,644.10 | $8,098 | 1.9× |
| N-invas est c ffr sw aly CTA (75580) | $1,916.55 | $4,259 | 1.5× |
| Neck soft tissue (70360) | $394.20 | $876 | 3.1× |
| Nm csf leak detection (78650) | $1,411.20 | $3,136 | 0.7× |
| Nm myocard infarct spect (78469) | $2,151.45 | $4,781 | 2.7× |
| Nonvascular Shunt X-Ray (75809) | $207.90 | $462 | 1.4× |
| Nuclear Rx Intra-Arterial (79445) | $441.45 | $981 | 1.3× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$896.85–$2,480.40 | $1,993–$5,512 | varies |
| Panoramic X-ray of jaws (70355) | $347.85 | $773 | 2.7× |
| Parathyroid Planar Imaging (78070) | $1,245.15 | $2,767 | 2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,141.65 | $2,537 | 2.0× |
| Pelvis 1 or 2 views (72170) | $473.40 | $1,052 | 3.1× |
| Pet Image W/Ct Lmtd (78814) | $5,575.95 | $12,391 | 2.7× |
| PET image w/CT, full body (78816) | $6,319.35 | $14,043 | 3.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,195.60 | $13,768 | 3.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,175.30 | $4,834 | 3.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $796.05 | $1,769 | 5.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $790.20 | $1,756 | 1.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $759.60 | $1,688 | 5.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $643.05 | $1,429 | 4.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $600.75 | $1,335 | 4.7× |
| Radex Sinuses Paransl < 3 Views (70210) | $304.20 | $676 | 2.4× |
| Radex Spine 1 View Specify Level (72020) | $475.65 | $1,057 | 3.7× |
| Radex Sternum Minimum 2 Views (71120) | $414.45 | $921 | 3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $647.10 | $1,438 | 5.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $486.45 | $1,081 | 3.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $518.40 | $1,152 | 3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $777.15 | $1,727 | 5.1× |
| Radiologic exam colon double contrast study (74280) | $1,324.35 | $2,943 | 5.2× |
| Radiologic exam colon single contrast study (74270) | $945.90 | $2,102 | 3.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $492.75 | $1,095 | 1.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $705.15 | $1,567 | 4.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$865.35–$891.90 | $1,923–$1,982 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$837.45–$872.10 | $1,861–$1,938 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$492.75–$895.50 | $1,095–$1,990 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $699.75 | $1,555 | 4.6× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $345.60 | $768 | 1.0× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $2,661.75 | $5,915 | 4.6× |
| Renal Cyst Study (74470) | $443.70 | $986 | 0.6× |
| Ribs bilateral 3 views (71110) | $917.55 | $2,039 | 6.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,175.40 | $2,612 | 2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,351.25 | $5,225 | 4.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,177.10 | $4,838 | 2.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,679.20 | $8,176 | 4.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,569.05 | $5,709 | 3.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,679.20 | $8,176 | 1.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $4,180.05 | $9,289 | 2.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,679.20 | $8,176 | 1.9× |
| Rp Therapy Intravenous Administration (79101) | $446.40 | $992 | 1.3× |
| Skull less than 4 views (70250) | $427.50 | $950 | 2.8× |
| Spleen Imaging (78185) | $1,784.70 | $3,966 | 3.1× |
| Sternoclavicular joints (71130) | $489.15 | $1,087 | 3.8× |
| Testicular Imaging W/Flow (78761) | $1,032.75 | $2,295 | 1.8× |
| Thoracic spine 2 views (72070) | $725.85 | $1,613 | 4.7× |
| Thoracic spine 3 views (72072) | $815.85 | $1,813 | 5.3× |
| Thoracolumbar 2 views (72080) | $461.25 | $1,025 | 3.6× |
| Thyroid Imaging With Vascular Flow (78013) | $546.30 | $1,214 | 0.9× |
| Thyroid Met Imaging Body (78018) | $2,866.50 | $6,370 | 3.6× |
| Thyroid Uptake Measurement (78012) | $546.30 | $1,214 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $621 | $1,380 | 1.1× |
| Ultrasound Exam Aaa Screen (76706) | $999.90 | $2,222 | 6.5× |
| Ultrasound, abdomen limited (76705) | $1,294.20 | $2,876 | 8.5× |
| Umbilical-artery Doppler (OB) (76820) | $447.75 | $995 | 2.9× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$530.10–$841.50 | $1,178–$1,870 | varies |
| Urethrocystogram voiding (74455) | $530.55 | $1,179 | 1.5× |
| Urethrocystography retrograde (74450) | $530.55 | $1,179 | 1.5× |
| Us exam, pelvic, limited (76857) | $906.30 | $2,014 | 5.9× |
| Us head (76506) | $1,029.15 | $2,287 | 6.7× |
| Us kidney transplant (76776) | $578.70 | $1,286 | 3.8× |
| Us ob detailed single fetus (76811) | $1,172.70 | $2,606 | 3.4× |
| Us ob limited 1 or more fetuses (76815) | $741.60 | $1,648 | 4.8× |
| Us ob transvaginal (76817) | $833.40 | $1,852 | 5.4× |
| Us pelvic non ob complete (76856) | $1,352.25 | $3,005 | 8.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $845.10 | $1,878 | 5.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $958.05 | $2,129 | 6.3× |
| Us retroperitoneal complete (76770) | $1,549.80 | $3,444 | 10.1× |
| Us retroperitoneal limited (76775) | $310.05 | $689 | 2.0× |
| Us scrotum and contents (76870) | $1,483.65 | $3,297 | 9.7× |
| Us spinal canal and contents (76800) | $886.50 | $1,970 | 5.8× |
| Us thyroid (76536) | $1,396.80 | $3,104 | 9.1× |
| Vascular Flow Imaging (78445) | $1,316.25 | $2,925 | 2.3× |
| Vein X-Ray Chest (75827) | $1,345.50 | $2,990 | 0.6× |
| Venography caval inferior serialography rs&i (75825) | $4,205.70 | $9,346 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $1,086.30 | $2,414 | 0.5× |
| Venography Renal Bilateral (75833) | $2,685.15 | $5,967 | 0.6× |
| Venous sampling by catheter (75893) | $4,922.55 | $10,939 | 0.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $386.10 | $858 | 3.0× |
| X-Ray Aorta Leg Arteries (75630) | $3,723.75 | $8,275 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $773.55 | $1,719 | 5.1× |
| X-Ray Exam Breast Specimen (76098) | $695.25 | $1,545 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $272.25 | $605 | 2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $523.35 | $1,163 | 3.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $502.20 | $1,116 | 3.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $2,277.45 | $5,061 | 14.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $2,562.30 | $5,694 | 16.8× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$1,177.65–$1,225.35 | $2,617–$2,723 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $593.10 | $1,318 | 4.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,026 | $2,280 | 6.7× |
| X-ray IV pyelogram (ivp) (74400) | $4,616.10 | $10,258 | 18.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $450.90 | $1,002 | 3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $741.15 | $1,647 | 5.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$657–$684.45 | $1,460–$1,521 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,211.85 | $2,693 | 7.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $804.60 | $1,788 | 5.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $670.50 | $1,490 | 5.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $383.40 | $852 | 3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $543.15 | $1,207 | 3.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,308.05 | $5,129 | 4.5× |
| X-Rays Bone Length Studies (77073) | $527.40 | $1,172 | 3.4× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$1,002.60–$1,043.10 | $2,228–$2,318 | varies |
| Xr c-spine 4 or 5 views (72050) | $800.55 | $1,779 | 5.2× |
| Xr facial bones less than 3 views (70140) | $531 | $1,180 | 4.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $261 | $580 | 1.7× |
| Xr orbits complete 4 views (70200) | $452.70 | $1,006 | 3.0× |
| Xr Tomogram Single Plane (76100) | $914.85 | $2,033 | 6.0× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.